Individualized Wheelchair Seating: Reducing Restraints and Improving Comfort and Function

This article addresses the problems associated with standard sling-type wheelchairs used by many older people and the need for individualized wheelchair seating based on assessments by physical and/or occupational therapists. Standard sling-type wheelchairs have many detrimental effects on the physical and social functioning of older people. They also often lead to the use of physical restraints because the older person is unable to maintain a sitting posture in such chairs. Wheelchairs that fit the individual and support postural abnormalities usually eliminate the need for restraints. The steps in an individualized assessment are described. The goal of individualized seating is to provide stability without compromising comfort and function. The older person's body contours, curvatures, joint range of motion, and measurements are documented and used to order wheelchair components to fit that person. Guidelines and suggestions for obtaining reimbursement for wheelchairs are presented.